| NPI | 1184746869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES LEE DAVENPORT Owner 423-542-4189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 34068) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 36009) |
| 208000000X Pediatrics (Licence: TN 36009) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2010-01-14 |